title: Strategies for improving outcomes in NSCLC: a look to the future.
abstract: Advances in the management of non-small cell lung cancer (NSCLC) over the past 30 years have led to small increases in 5-year survival rates across Europe, though further improvements may require new treatment strategies. In order to improve efficiency and reduce the cost of development, future trials for new targeted agents in NSCLC should aim to recruit patients on the basis of tumour biology rather than clinical characteristics. However, identification of predictive biomarkers is required to maximise the benefits of new approaches and expedite the drug development process. Nevertheless, the NSCLC landscape is changing rapidly, and recent improvements in our understanding of the molecular biology of the disease will help in the identification of novel targeted agents as well as assisting in the development of personalised strategies for the numerous small subsets of defined NSCLC. Progress in imaging and treatment delivery is also likely to improve outcomes for patients with the disease. This article outlines recent progress in the treatment of NSCLC, identifies current challenges and describes proposals for improving the future management of the disease. It is hoped that implementation of some of these strategies will go some way to improving the outlook for patients with NSCLC.
authors.affiliation: Department of Oncology, University Hospital Zurich, Zurich, Switzerland. Electronic address: Rolf.stahel@usz.ch.
authors.forename: Rolf
authors.initials: R
authors.lastname: Stahel
authors.forename: Solange
authors.initials: S
authors.lastname: Peters
authors.forename: Paul
authors.initials: P
authors.lastname: Baas
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Brambilla
authors.forename: Federico
authors.initials: F
authors.lastname: Cappuzzo
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.forename: Wilfried Ernst Erich
authors.initials: WE
authors.lastname: Eberhardt
authors.forename: Enriqueta
authors.initials: E
authors.lastname: Felip
authors.forename: Dean
authors.initials: D
authors.lastname: Fennell
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchetti
authors.forename: Luis
authors.initials: L
authors.lastname: Paz-Ares
authors.forename: Alex A
authors.initials: AA
authors.lastname: Adjei
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000378:metabolism; D035843:Biomedical Research; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000628:therapy*; D005060:Europe; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D058990:Molecular Targeted Therapy / Q000639:trends*; D057285:Precision Medicine; D011379:Prognosis; D058996:Quality Improvement; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Biomarkers; Clinical trials; Lung cancer; Management; Molecular profiling; Outcomes; Pathogenesis; Treatment